This invention relates to the treatment of nonacne inflammatory dermatoses, infectious cutaneous diseases, and hair loss resulting from inflammation or hormonal anomalies. In particular, this invention is directed toward conditions involving inflammation or infection of the adnexa, dermis and epidermis or hormonal involution of hair follicles including such dermatoses as rosacea, perioral dermatitis, eczema, seborrheic dermatitis, psoriasis, tinea cruris, flat warts, alopecia areata, male pattern baldness and similar conditions.
The present invention resides in the discovery that certain dicarboxylic acids are effective in the treatment of these conditions, and represents a departure from the types of skin conditions on which such acids have previously been disclosed as effective.
U.S. Pat. Nos. 4,292,326 (Nazarro-Porro, Sept. 29, 1981) and 4,386,104 (Nazarro-Porro, May 31, 1983) disclose the use of dicarboxylic acids in the treatment of acne and melanocytic hyperpigmentary dermatoses. Acne is a sebaceous gland abnormality with inflammatory papules, pustules, and cysts and noninflammatory comedos. It afflicts teenagers and young adults. Melanocytic hyperpigmentary disorders are noninflammatory conditions involving an excess of melanin formation in the skin. The producing cells may be benign, premalignant, or malignant.
Nonacne inflammatory dermatoses are quite distinct from acne in a number of ways, including the distribution and morphology of lesions, the pathologic sites microscopically, the lack of spontaneous resolution, the types of and the response to treatment, and the age groups most susceptible. Infectious cutaneous diseases include all microbial and fungal invasive organisms and infestations that may be transmitted to other skin sites on the person or to other persons. Hair loss results from a variety of diseases including inflammatory conditions like alopecia areata and hormone hypersensitivity like male pattern baldness.
Rosacea is a chronic disease of the flush area of the face characterized by a heightened vascular response. It begins as a prominent intermittent flush which becomes permanent followed by telangectasias. Later papules and pustules but no comedos develop. It occurs most commonly in women over 30 years of age. Antibiotics and corticosteroids are commonly used for treatment, but response is usually poor.
Perioral dermatitis occurs primarily in young women and is characterized by erythema, papules, papulovesicles and intermittent eczematous plaques of the chin, nasolabial folds, and upper lip. Itching and burning are often present. The usual treatment consists of antibiotics and corticosteroids.
Seborrheic dermatitis is a histopathologically eczematous dermatosis characterized by poorly demarcated scaley erythematous patches with yellowish greasy scales. "Dandruff" is a mild form of this condition localized to the scalp. This disease may involve any one, several, or all of the following sites: scalp, eyebrows, glabella, paranasal and chin folds, ears and retroauricular sulci, presternal interscapular regions, pubic regions and intergluteal folds. Corticosteroids with tar, sulfur, or antibiotics give temporary control in some cases.
Psoriasis is a common chronic proliferative epidermal disease characterized by keratinocyte epidermal transit time being increased by ninefold. The lesions are sharply demarcated thick erythematous plaques with abundant white scale. The most commonly involved sites include elbows, knees, scalp, genitalia, and gluteal fold. Nail abnormalities are very common and joint disease occurs infrequently. Therapy ranges from topical tar, anthralin, and corticosteroids to systemic methotrexate, psoralens and ultraviolet A light, and ultraviolet B light.
Eczematous dermatitis is a pathologic state of epidermal spongiosus that is the end result of a variety of diseases. These include atopic diathesis, allergic and irritant contact reactions, photo allergic and photo toxic reactions, drug eruptions, and severe asteatosis. The site of the eruption depends on the insulating disease. Current therapy consists of topical and systemic corticosteroids and topical tar.
Tinea cruris "jock itch" is a fungal or fungal/yeast infection of the groin and pubic areas. The infecting organisms may spread to other skin areas and may be transmitted to other people. Present therapy consists of topical and systemic antibiotics.
These are examples of conditions for which it has been discovered that dicarboxylic acids within the scope of the present invention are an effective treatment when applied topically. In general, the invention applies to nonacne inflammatory and infectious conditions of the skin or the skin regions such as, for example, the dermis, epidermis and adnexa, and also to alopecias resulting from inflammatory disease states or from hormonal abnormalities.